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Virus drugmaker fights pediatricians’ new advice

By WTOP Staff

LINDSEY TANNER
AP Medical Writer

CHICAGO (AP) — A costly drug given mostly to premature babies is at the center of a clash between the manufacturer and the nation’s leading pediatrician’s group, which recommends scaling back use of the medicine.

The dispute involves new guidelines from the American Academy of Pediatrics, which say medical evidence shows the drug benefits few children other than very young preemies. The medicine guards against a common but usually mild virus that can cause serious lung problems.

It’s the second time in two years that the influential group has recommended narrowing use of the drug, sold by MedImmune under the brand name Synagis (SIN’-uh-jis). MedImmune is fighting back with full-page newspaper ads that say the updated policy threatens “our most vulnerable babies.”

Synagis protects against RSV, or respiratory syncytial (sin-SISH’-uhl) virus, which infects nearly all U.S. children by the age of 2. For most, it causes only mild, cold-like symptoms. But it is also the most common cause of pneumonia in U.S. infants, and as many as 125,000 young children are hospitalized with RSV each year, according to the federal Centers for Disease Control and Prevention.

It was approved in 1998 for use in certain “high-risk” children, based on research showing benefits for certain children including premature infants born at 35 weeks or earlier. The pediatricians’ group says it has sought to provide more specific guidance because the government’s definition of high risk is vague.

The medicine is given in a series of seasonal injections costing thousands of dollars, and a recent lag in Synagis sales may explain MedImmune’s tactics, which include recruiting parents to help tout the drug.

Sales for the first quarter of 2014 totaled $328 million, down 19 percent from $414 million in the same period last year, according to an earnings report from parent company AstraZeneca.

Company spokeswoman Alisha Martin said it placed full-page ads in The New York Times and several other newspapers because “we felt it important to inform parents — including the half-a-million women who give birth prematurely each year — of the decisions being made that could impact the lives of their children.”

Studies show the drug can slightly reduce risks for being hospitalized but doesn’t shorten hospital stays or lessen chances for long-term complications or death, said Dr. H. Cody Meissner, a member of an academy committee involved in drafting the new guidance and an infectious disease expert at Tufts Medical Center.

Advances in treatment for preemies in recent years make Synagis, also known as palivizumab (pah-lih-VIH’-zu-mahb), unnecessary for many, the academy says. Its new guidance recommends it only for: infants born before 29 weeks; older preemies with chronic lung disease and those with certain heart problems; and certain other at-risk children younger than age 2.

Healthy older preemies should not get the drug, the academy says in guidelines published online Monday. Its 2012 advice included use in some older, healthy preemies.

Melony Sorbero, a senior Rand Corp. researcher, has studied RSV and said the academy’s narrowed recommendations make sense based on scientific evidence of limited benefits.

MedImmune’s newspaper ads say the new guidelines will leave about 140,000 infants born between 29 and 35 weeks “unprotected.” The ads say: “Why put these babies at risk?” They include a photo of a tiny preemie hooked up to medical machinery.

A Washington, DC-area mother, Deb Discenza, has helped the drugmaker locate parents to participate in a MedImmune RSV awareness program and says she was paid for sharing information about her daughter’s experience. Her daughter was born at 30 weeks, or about two months early, in 2003. The baby may not have qualified for the medicine under the academy’s new guidance but her mother believes Synagis treatment that first year “is what saved us.”

The little girl’s doctor declined to offer the drug after she turned 1, and she developed asthma. Discenza believes Synagis might have prevented it.

She said her health insurance covered the shots, but she’s among parents who worry coverage will be denied based on the new recommendations.

Susan Pisano, spokeswoman for the industry group America’s Health Insurance Plans, says insurers consider medical groups’ recommendations but that it’s too soon to determine if the pediatricians’ new advice will affect coverage decisions.

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Online:

American Academy of Pediatrics: http://www.aap.org

RSV: http://www.cdc.gov/RSV/

MedImmune: http://www.Medimmune.com

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

Copyright 2014 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Don’t Settle for Student Loans to Pay for Online Education

By WTOP Staff
Online college programs are becoming a more popular choice for prospective students, with one study finding that more than 6 million students enrolled in at least one online course in fall 2015. The popularity of these courses can be attributed in part to their flexibility with working adults' schedules, students' ability to progress more quickly through online programs and, oftentimes, cheaper tuition. [See 10 low-cost online bachelor's programs for out-of-state students.]Online degrees can be beneficial to many college students, but some studies have shown online learners complete their programs at lower rates than students at traditional brick-and-mortar campuses. Individuals with student loans but no degree comprise two-thirds of defaulted borrowers. Though these numbers are not encouraging, just like for traditional programs, there are ways to reduce how much you'll need to borrow for an online program to ensure you won't become one of these statistics. Don't just settle on borrowing student loans to cover the whole cost of your program and living expenses. Instead, start thinking about how to cut costs and cover your balance in different ways, such as the following. -- Grants and scholarships: Even though you are taking an online course, you can still apply and receive grants and scholarships. But your first step should be to complete the Free Application for Federal Student Aid, commonly referred to as the FAFSA, which will allow you to receive a Pell Grant if your expected family contribution is low enough. The EFC criteria and award amounts are adjusted annually, but the 2017-2018 academic year awards range from $606 to $5,920, which could significantly lower the amount you borrow annually. Your next step is to apply for scholarships. You can start by checking online scholarship search engines, such as the Salt Scholarship Search, College Board's BigFuture and Peterson's. But don't forget to take advantage of local organizations and your school's financial aid office. Both may offer scholarships that you can't find with a national scholarship search. [Review these 10 sites to kick off your scholarship search.]For instance, organizations like the Elks Club, Knights of Columbus or the Rotary Club typically offer scholarships annually to local students. Just because you're going to school online doesn't mean you're ineligible. Visit your local library for scholarship listings, and ask around town. You might be surprised how many local organizations offer scholarships. While these scholarships typically aren't large, every little bit counts. Each dollar you receive in a scholarship is a dollar you don't have to borrow and pay interest on. -- Work-study: Another option for online students may be work-study awards. Not all students enrolled in online programs are eligible, but students at some schools -- including, for example, SUNY Empire State College and Liberty University -- are. Work-study awards are not given upfront like scholarships and grants. In most cases, they are an offer to earn up to the awarded amount if you secure an eligible work-study job. While there is a misconception that all work-study jobs must be on campus, students can work for off-campus, nonprofit or public employers as long as the work is in the public's interest. You may be able to work for a for-profit employer if the job is relevant to your course of study. No matter who the outside employer is, it will need to have an established agreement with your college for you to receive work-study funds. Remember, to be eligible for federal financial aid, you must be enrolled and pursuing a degree or certificate. If you're not working toward a credential, Pell Grants and work-study won't be option, but you may still be able to take advantage of private scholarships -- just be sure to read the eligibility criteria carefully. [Explore what to know about financial aid in online programs.]-- Pay as you go: One of the great benefits to enrolling online is the flexible schedule, which can allow you to complete your college coursework around your responsibilities. But prospective students often overlook using their part- or full-time job earnings as an option for paying for college. Almost 80 percent of college students in 2015 worked at least part time while attending classes, according to the National Center for Education Statistics. By budgeting and thinking strategically about your college costs, you can likely reduce your dependence on student loans by paying a portion out of pocket. Many -- but not all -- online programs are less expensive than traditional programs and often have shorter payment periods. Six, eight or 10 weeks are common course durations. Because of the frequency of payments in an online setting, you may be well-placed to pay as you go and possibly avoid borrowing altogether. Attending college online and avoiding student loans may be challenging, but if you are willing to put in the effort, you can limit the amount you need to borrow. More from U.S. News Q&A: Understanding Student Loan Discharge Eligibility Student Loan Refinancing Isn't Right for All Borrowers
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